Year 2022 / Volume 114 / Number 5
Letter
Misplacement of the PEG tube through the transverse colon, an uncommon but possible complication

296-297

DOI: 10.17235/reed.2022.8501/2021

David Viso Vidal, Francisco Jorquera Plaza,

Abstract
Misplacement of the Percutaneous Endoscopic Gastrostomy (PEG) tube through the transverse colon mainly by traction is an uncommon complication probably due to inadvertent puncture of colon during PEG placement, resulting in gastrocolocutaneous fistula. Stool drainage through the stoma is usually the only symptom. We report a 52-year-old male with Wernicke-Korsakoff syndrome and PEG tube placement 7 months earlier and replacement one month ago. Due to stool drainage through the stoma was observed, he was performed a computed tomography (CT) in which PEG tube was visualized lodged in transverse colon without pneumoperitoneum associated. Due to important morbility, endoscopic management was decided. Balloon was removed through cutaneous orifice and Ovesco clip was placed simultaneously, achieving a complete closure of wall defect. Although spontaneous closure of the fistula usually happens, surgery is sometimes required, with endoscopic treatment being a less invasive and effective alternative to solve this complication.
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References
1. Kajihara Y, Mizuki I. Gastrocolocutaneous Fistula Caused by Percutaneous Endoscopic Gastrostomy. Chonnam Med J 2020; 56: 81-82.
2. Nunes G, Paiva de Oliveira G, Cruz J, et al. Long-Term Gastrocolocutaneous Fistula after Endoscopic Gastrostomy: How Concerned Should We Be?. GE Port J Gastroenterol 2019; 26: 441–47.
3. Lee J, Kim J, Kim H et al. Gastrocolocutaneous fistula: an unusual case of gastrostomy tube malfunction with diarrhea. Clin Endosc 2018; 51: 196 – 200.
4. Ligresti D, Barbuscio I, Granata A, et al. Endoscopic closure of gastrocolocutaneous fistula following percutaneous endoscopic gastrostomy, by OverStitch Endoscopic Suturing System. Endoscopy 2019; 51: 384-85.
5. Büyükaşık K, Tatar C, Arı A, et al. Successful endoscopic treatment of a gastrocolocutaneous fistula due to PEG tube. Turk J Gastroenterol. 2017; 28: 231–32.
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Viso Vidal D, Jorquera Plaza F. Misplacement of the PEG tube through the transverse colon, an uncommon but possible complication. 8501/2021


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Publication history

Received: 06/12/2021

Accepted: 17/12/2021

Online First: 10/01/2022

Published: 06/05/2022

Article revision time: 8 days

Article Online First time: 35 days

Article editing time: 151 days


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